J.D.'s teenage burn patient gives him a hard decision to make when he wants to go to his high school graduation. Turk doesn't want Carla to find out that he secretly learned Spanish. And to address Dr. Kelso's weight gain, Dr. Cox makes a game out of stealing his breakfast.

Dr. Cox had a patient that he hadn't been able to diagnose for two years, and he is back again. Dr. Kelso has to face a retirement board when his true age is revealed. Elliot and Carla try to find enough people in favor of Dr. Kelso to keep him as Chief of Medicine.